Local Anaesthetics MCQs (from Louis)

1. Regarding local anaesthetics, which is incorrect:

a. Blood levels will be 30% lower with added vasoconstrictors leading to enhanced neuronal uptake
b. A lower pH means that more of the anaesthetic will be in the uncharged form and thus less effective
c. Systemic absorption is greater when injecting highly vascular sites like the tracheal mucosa
d. Ester-based local anaesthetics will be rapidly broken down in the plasma
2. The following are all examples of amide local anaesthetics except:
a. Lignocaine
b. Bupivacaine
c. Tetracaine
d. Ropivicaine
3. The following are all examples of ester local anaesthetics except:
a. Priolocaine
b. Procaine
c. Cocaine
d. Benzocaine
4. Regarding local anaesthetics, which is correct:
a. Unmyleinated A fibres are the most sensitive to block
b. Primary action is blockade of ligand-gated sodium channels
c. Hepatic disease will cause increased toxicity from the ester local anaesthetics
d. Repeated injections of local anaesthetic can result in tachyphylaxis
5. Regarding the effects of local anaesthetics which is incorrect:
a. At least 2 nodes of Ranvier need to be blocked to prevent AP propagation in a myelinated nerve
b. Unmyelinated nerves tend to be blocked before myelinated nerves of the same diameter
c. Sensory fibres are preferentially blocked because they have a higher rate of firing and a longer AP
d. Block of a large nerve will result in sensory analgesia that starts proximally and spreads distally
6. Toxicity due to local anaesthetics includes all of the following except:
a. Direct neural toxicity
b. Direct and indirect cardiotoxicity
c. Seizures
d. Methaglobulin accumulation

ANSWERS
1. B
2. C
3. A
4. D
5. B

6. D